Active NPI
Andrea Marie Gurciullo, LAC
- Acupuncturist
- North Haledon, NJ
National Provider Identifier
1477873214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 25MZ00132-00
- Practice address
- 475 High Mountain Rd
North Haledon, NJ 07508-2664 - Phone
- (516) 425-4575
- Fax
- (516) 568-7789
- NPI assigned
- Jun 3, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 25MZ00132-00 | NJ | Primary |
Addresses
Primary practice location
475 High Mountain Rd
North Haledon, NJ 07508-2664
Mailing address
475 High Mountain Rd
North Haledon, NJ 07508-2664
Phone (516) 425-4575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MZ00132-00 | NJ | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proclinix Sports Physical Therapy Chiropractic Wellness,PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Armonk, NY
- NPI 1114132511
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301961600000",
"number": "1477873214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 HIGH MOUNTAIN RD",
"city": "NORTH HALEDON",
"state": "NJ",
"postal_code": "075082664",
"telephone_number": "516-425-4575",
"fax_number": "516-568-7789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 HIGH MOUNTAIN RD",
"city": "NORTH HALEDON",
"state": "NJ",
"postal_code": "075082664",
"telephone_number": "516-425-4575",
"fax_number": "516-568-7789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GURCIULLO",
"first_name": "ANDREA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-03",
"last_updated": "2011-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NJ",
"license": "25MZ00132-00",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Haledon, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.